Fatal Fat Embolism Syndrome Without Recognized Fracture in Patients With Duchenne Muscular Dystrophy: Two Case Reports

BACKGROUND: Fat embolism syndrome (FES) is an uncommon cause of sudden death in patients with Duchenne muscular dystrophy (DMD), typically following identifiable fractures. METHODS: We present two cases of sudden fatal FES in the setting of DMD without clinically recognized trauma or fracture. The first was a 7-year-old boy who had autism spectrum disorder and who also had sudden death after collapsing at home following a walk with no recognized trauma. The second was a 23-year-old man who developed sudden respiratory failure without preceding illness or injury that progressed to shock and subsequent death. RESULTS: Autopsy in both cases revealed extensive fat emboli in the microvasculature in multiple organs. CONCLUSIONS: These cases underscore the risk of FES in patients with DMD without apparent preceding injury.